This year’s proposal in Ryan’s budget would likely result in similarly severe cuts. The Urban Institute also estimated that the 2012 block grant proposal would have resulted in cuts in reimbursements to health care providers and managed care plans of more than 30 percent by the tenth year. (That would be in addition to the 13 million people who would lose their new coverage or no longer gain coverage in the future due to repeal of the Medicaid expansion, with the number rising as high as 17 million if all states take up the expansion.) More than 40 million people would likely end up losing coverage overall after also taking into account the budget’s repeal of health reform’s exchange subsidies. The Urban Institute similarly estimated that the 2012 block grant proposal would lead states to drop between 14.3 million and 20.5 million people from Medicaid by the tenth year. In its analysis of the similar block grant from the House’s budget plan in 2012, however, the Congressional Budget Office (CBO) concluded that unless states increased their own Medicaid funding very substantially to make up for the Ryan plan’s deep Medicaid funding cuts, they would have to take such steps as cutting eligibility, which would lead to more uninsured low-income people cutting covered health services, which would lead to more underinsured low-income people and/or cutting the already low payment rates to health care providers, which would likely cause more doctors, hospitals, and nursing homes to withdraw from Medicaid and thereby reduce beneficiaries’ access to care. In addition, its per-beneficiary costs have been rising more slowly than private insurance premiums for the past decade, and they are expected to grow no faster than private insurance over the next ten years.Ĭhairman Ryan claims in his budget plan that the block grant would ease states’ fiscal burdens, improve the safety net for low-income Americans, and provide better access to care among beneficiaries. The program already costs significantly less per beneficiary than private insurance does, because it pays health providers much lower rates and has considerably lower administrative costs. Medicaid cannot readily withstand cuts of this depth without harmful results for low-income families and individuals. (See Figure 1.) These cuts would come on top of repealing the health reform law’s Medicaid expansion.Ĭuts of this magnitude would substantially - and adversely - affect millions of low-income Americans’ ability to secure health coverage and access needed health-care services. The Medicaid block grant proposal in the budget plan proposed by House Budget Committee Chairman Paul Ryan on April 1 would cut federal Medicaid (and the Children’s Health Insurance Program, or CHIP) funding by 26 percent by 2024, because the funding would no longer keep pace with health care costs or with expected Medicaid enrollment growth as the population ages.
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